RODRIGUES, Anderson da Silva. Avaliação do impacto do projeto hora de plantar sobre a sustentabilidade dos agricultores familiares da microrregião do Cariri (CE): o caso do milho híbrido. 2016. 250f. Tese (Doutorado em Desenvolvimento e Meio Ambiente)- Universidade Federal do Ceará, Fortaleza, 2016. / Submitted by Weslayne Nunes de Sales (weslaynesales@ufc.br) on 2017-01-26T14:59:57Z No. of bitstreams: 1 2016_tese_asrodrigues.pdf: 2147838 bytes, checksum: b4d7cc53e72f928b06f20bc7db1e8487 (MD5) / Approved for entry into archive by Jairo Viana (jairo@ufc.br) on 2017-01-26T17:46:39Z (GMT) No. of bitstreams: 1 2016_tese_asrodrigues.pdf: 2147838 bytes, checksum: b4d7cc53e72f928b06f20bc7db1e8487 (MD5) / Made available in DSpace on 2017-01-26T17:46:39Z (GMT). No. of bitstreams: 1 2016_tese_asrodrigues.pdf: 2147838 bytes, checksum: b4d7cc53e72f928b06f20bc7db1e8487 (MD5) Previous issue date: 2016 / The Projeto Hora de Plantar (Project Time to Plant), was structured from the program Arrancada da Produção (Production Growth), in 1987, is the subsidized distribution to family farmers of the genetically selected seed, in order to ensure greater productivity and the need to adapt to climatic conditions rustic Northeastern. With integration of actions to promote the sustainability in the various Sustainable Rural Development Plans implemented after 1995, the Projeto Hora de Plantar is in addition to increased income and increase core productivity of beneficiaries, other objectives, such as: encouraging the adoption of agricultural practices for coexistence with the semi-arid and support to the forestation and reforestation through the distribution of native and exotic plant species. With the Programa do Milho Híbrido (Hybrid Maize Program), created in 1999, the distribution of hybrid maize seed becomes part of the list of cultures promoted by Projeto Hora de Plantar. In 2015, 2,227 tons of seeds were distributed and benefited producers 75,880 Brazil, representing about 65% of the seeds distributed by the project. The present study has a main objective to evaluate the impact promoted by the Projeto Hora de Plantar about the sustainability of the agricultural producers of hybrid maize farmers from the Cariri Microregion from Ceará by building an Index of Sustainability of Production (ISP), which covers the economic, environmental and technological dimensions. Using primary source data, obtained through 210 semi-structured questionnaires, being 90 to beneficiaries and 120 producers not to beneficiaries of the programme, implemented in the municipalities of Barbalha, Nova Olinda and Santana do Cariri, located in the Cariri Microregion. The comparison between treatment group (beneficiares) and control(not beneficiaries) was performed by the application of the technique of propensity score matching. The results show that the Index of Sustainability of Production among the beneficiaries is significantly higher than that of non-beneficiaries. In relation to the components of the ISP, the beneficiaries showed statistically significant superiority in economic and technological dimensions. With regard to the environmental dimension, no statistically significant differences were found between the groups. The sensitivity analysis of the model confirms the robustness of the results estimated. Therefore, it is concluded that the beneficiaries of the project family farmers time to plant presented a higher level of agricultural sustainability in relation to non-beneficiaries. / O Projeto Hora de Plantar foi estruturado a partir do programa Arrancada da Produção, em 1987, e consiste na distribuição subsidiada, aos agricultores de base familiar, de sementes geneticamente selecionadas, de modo a garantir maior produtividade e a necessária rusticidade para adaptação às condições edafoclimáticas nordestinas. Com a inserção de ações de promoção da sustentabilidade nos diversos Planos de Desenvolvimento Rural Sustentável, implementados após 1995, o Projeto Hora de Plantar passa a ter, além do objetivo principal de aumento de renda e produtividade dos beneficiários, outros objetivos, como: o incentivo à adoção de práticas agrícolas de convivência com o semiárido e o apoio ao florestamento e reflorestamento através da distribuição de espécies vegetais nativas e exóticas. Com o Programa do Milho Híbrido, criado em 1999, a distribuição de sementes de milho híbrido passa a integrar o rol das culturas promovidas pelo Projeto Hora de Plantar. Em 2015, foram distribuídas 2.227 toneladas de sementes e beneficiados 75.880 produtores cearenses, representando cerca de 65% das sementes distribuídas pelo projeto. O presente estudo tem como objetivo principal avaliar o impacto promovido pelo Projeto Hora de Plantar sobre a sustentabilidade agrícola dos agricultores familiares produtores de milho híbrido da Microrregião do Cariri Cearense mediante a construção de um Índice de Sustentabilidade da Produção (ISP), que contempla as dimensões econômica, ambiental e tecnológica. Utilizaram-se dados de origem primária, obtidos mediante 210 questionários semiestruturados, sendo 90 para produtores beneficiários e 120 para não beneficiários do programa, aplicados nos municípios de Barbalha, Nova Olinda e Santana do Cariri, localizados na Microrregião do Cariri. A comparação entre grupo tratamento (beneficiários) e controle (não beneficiários) foi realizada mediante a aplicação da técnica de Propensity Score Matching. Os resultados revelam que o Índice de Sustentabilidade da Produção entre os beneficiários é significativamente superior ao dos não beneficiários. Em relação aos componentes do ISP, os beneficiários apresentaram superioridade estatisticamente significativa nos índices das dimensões econômica e tecnológica. Quanto à dimensão ambiental, não foram encontradas diferenças estatisticamente significativas entre os grupos. A análise de sensibilidade do modelo corrobora a robustez dos resultados estimados. Portanto, conclui-se que os agricultores familiares beneficiários do projeto Hora de Plantar apresentaram maior nível de sustentabilidade agrícola em relação aos não beneficiários.

Bakgrund: Plantar fasciit är ett inflammatoriskt tillstånd i foten som uppstår till följd av mikrotrauman på senstråket som går under foten. Tillståndet oftast självläkande, men kan vara ihållande. Kan vara mycket smärtsamt och begränsande. Behandlingsmetoder som finns är stretching, tejpning, nattskena och fysioterapi. Stötvågsbehandling är behandlingsmetod som används vid stötvågsbehandling, anses vara en säker metod. Syfte: Kartlägga vilken effekt stötvågsbehandlingen hade på plantar fasciit avseende smärta och/eller funktion. Metod: För att besvara syftet utfördes en litteraturstudie. Sökningarna utfördes i två sökbaser, LTU:s sökbas och Pubmed. Resultat: 8 studier inkluderades och granskades. Stötvågsbehandling jämfördes med placebobehandling. Majoriteten avstudierna (fem av åtta) uppvisade goda resultat med statistiskt signifikans till fördel för stötvåg. Två av studierna uppvisade fördel till stötvåg, men det fanns ingen statistisk signifikans i studierna. Sista studien uppvisade ingen signifikant skillnad eller fördel till någon av grupperna. Stötvågsbehandling med medel- eller högeffekt uppvisade bättre resultat än lågeffekt i denna litteraturstudie. Radiell stötvåg hade mer tillförlitligt resultat än fokuserad stötvåg i denna sammanställning med. Konklusion: Stötvåg verkar kunna ha en positiv effekt på plantar fasciit avseende smärta och funktion. Stötvåg med medel- eller högeffekt är två alternativ för effekt. Radiell stötvåg kan även vara att föredra över fokuserad då den gav tillförlitligare resultat.

It was questioned whether a unilateral stretching program would induce a crosstraining effect in the contralateral muscle. To test this, 13 untrained individuals participated in a 10-week stretching program while 12 other untrained individuals served as a control group. For the experimental group, the right calf muscle was stretched 4 times for 30 seconds, with a 30-second rest between stretches, 3 d·wk -1 for 10 weeks. Strength determined via 1 repetition maximum (1RM) unilateral standing toe raise, and range of motion (ROM) were measured pre-post. In the treatment group, the stretched calf muscle had a significant (p < 0.05) 8% increase in ROM, whereas the nonstretched calf muscle had a significant 1% decrease in ROM. The 1 RM of the stretched calf muscle significantly increased 29%, whereas the 1RM of the nonstretched calf muscle significantly increased 11%. In the control group, neither 1RM nor ROM changed for either leg. The results indicate that 10 weeks of stretching only the right calf will significantly increase the strength of both calves. Hence, chronic stretching can also induce a crosstraining effect for strength but not for the ROM. This study also validates earlier findings suggesting that stretching can elicit strength gains in untrained individuals.

Patients with pes planovalgus deformity often have coexisting spring ligament pathology. A primary repair of the ligament may fail during weightbearing due to chronic degeneration of the ligamentous tissue. Augmentation with a suture tape has been suggested to strengthen the repair. Limited data exist regarding flatfoot reconstruction with augmented spring ligament repair using a suture tape. This is a review of 57 consecutive patients who had flatfoot reconstruction with concomitant spring ligament augmented repair between July 2014 and August 2017. Weightbearing radiographic parameters were obtained preoperatively and compared to radiographs at an average time of 62 ± 46.5 (range 20-220) weeks postoperative. Significant improvements were seen in the radiographic parameters evaluated. Five patients had subsequent operations including one deep infection, 2 hardware removals remote to the spring ligament augmentation, 1 ankle arthrodesis, and 1 triple arthrodesis. Concomitant spring ligament repair augmented with a suture tape was a safe procedure that contributed to radiographic correction in a consecutive series of 57 patients undergoing flatfoot deformity correction.

The plantar plate is a fibrocartilaginous tissue beneath the metatarsophalangeal joint (MTPJ). Plantar plate function centers around maintaining the static stability of the MTPJ, and its integrity facilitates the dynamic stabilizing functions of surrounding soft tissue structures. Injury to the plantar plate can cause significant forefoot discomfort focused around the MTPJ, swelling, and altered forefoot biomechanics from toe instability. Significant injury like either partial or complete tear of the plantar plate commonly requires surgical intervention to repair the tissue. As fibrocartilage, the plantar plate lacks an intrinsic capacity for robust healing, thus requiring a surgical repair aiming to restore proper function. Existing plantar plate repair techniques afford different perspectives for restoring plantar plate biomechanical function, though room for improvement exists for an enhanced repair. Our senior design team developed a novel approach for plantar plate repair using a two-piece snap fitting permanent implant. This novel technique was reduced to practice and required further experimental analysis of its functional capacity to inform future development. Two methodologies were used to evaluate the novel implant device designed for plantar plate repair. An implant isolated mechanical testing protocol was developed to evaluate the implant and suture construct of the repair in anatomically relevant orientations. A human cadaver tissue model protocol was employed to evaluate the integrity of the native plantar plate tissue, a simulated conventional repair, and our novel implant fixation repair. These methodologies used uniaxial tensile testing with custom test configurations to evaluate the structural integrity and properties of the implant-suture construct and simulated tissue only or tissue-repair constructs, respectively. Our results provided encouraging support for the use of mechanical testing and the continued development of this novel implant device for plantar plate repair. Additionally, qualitative outcomes from this testing revealed additional avenues to improve the novel implant device in support of further advancing the product for future use in the field of podiatric medicine. / Master of Science / The plantar plate is a soft, biological tissue that lies beneath the metatarsophalangeal joint (MTPJ), which comprises the ball of the foot. When injured, the plantar plate lacks capacity to fully heal the tissue, as its structural properties more closely resemble that of cartilage and ligaments, which also commonly fail to fully heal after injury. Due to the difficulties in facilitating healing and restoring its function, a plantar plate tear or rupture is commonly repaired surgically. Current methods for repairing a plantar plate tear vary, though room to enhance the overall surgical repair technique exists. Our senior design team developed a novel implant device for use in a modified surgical repair of the plantar plate, which aimed to improve upon the existing methods. This work focused on developing experimental methods to analyze and evaluate the function of this novel implant device that is relevant to the clinical application of plantar plate repairs. Two experimental setups were developed and used to analyze the function of our novel implant device. A simulated repair setup, relevant to the natural function of the plantar plate, was employed to evaluate the function of the implant and suture used in the repair. A human cadaver model experimental setup aimed to evaluate the plantar plate naturally, a conventional or existing repair, and our novel repair of a simulated torn plantar plate. The outcomes from these experiments encourage further exploration of implant product development as well as continued testing of this device in the future. Ultimately, this work has provided a foundation for the continued development of our novel implant device for plantar plate repair with the aim to bring this product to market and enhance the field of podiatric medicine.

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No description available.

Background: Previous literature showed contradictory evidence on the subject of predictors of chemotherapy-induced Palmar Plantar Erythrodysesthesia (PPE). While there is evidence to suggest that dose and schedule of the drugs play a large role, the fact that many still go on to develop severe PPE following dose reduction would indicate that there are other factors involved. Since the incidence of PPE is more prevalent during the first three cycles of treatment this would also indicate that there are factors other than a cumulative effect. The contradictory evidence in the literature relates to biographical factors, performance status, co-morbidities and renal function. There is a lack of empirical evidence to support the theory that PPE is caused by damage to the microcapillaries due to everyday activities that cause friction or pressure to the hands or feet. Purpose: The aim of this exploratory study was to identify pre-treatment risk factors for the development of PPE prior to cycle four. Patients and methods: The study was made up of two phases, a retrospective phase and a prospective phase, using mixed strategies to collect data. Thus providing two independent samples to compare and validate or refute results. Phase I: A retrospective notes review of patients who had received Infusional 5FU or capecitabine containing regimes over a 1 year period (n=392). Phase II Prospective data collection from participants receiving capecitabine monotherapy (n = 125). Data was collected during semi-structured interviews, from participant's diaries, physical examination of the hands and feet and notes review. Data relating to activities that cause friction, pressure or heat were collected during this phase. Data from both samples were analysed independently using bivariate (chi-square and t-test) tests where each independent variable was analysed against PPE. The variables which achieved statistical significance were entered into a multivariate (binary logistic regression) model. The multivariate analysis employed a specific modelling algorithm using a relaxed alpha value applied to various entry methods to produce multiple models. The outcomes from these models were entered into a ROC curve test to establish which model was the best predictor of PPE. Results: Phase I The bivariate analysis demonstrated that those at most risk of developing PPE prior to cycle 4 of capecitabine monotherapy were males with non-metastatic colorectal cancer, who had either developed PPE with previous chemotherapy regimes or not had previous chemotherapy and who started their treatment during the winter months. When variables were combined in a multivariate logistic regression model, those that were associated with an increased risk of PPE were male, no metastatic spread, no inflammatory condition as co morbidity, smoked, did not drink, had weight loss prior to treatment, a low/normal pre treatment ALP level and started their treatment during the winter. Phase II: The bivariate analysis demonstrated that those at most risk of developing PPE prior to cycle 4 of capecitabine monotherapy were those with no metastatic disease, had an inflammatory condition as co morbidity, were receiving capecitabine as adjuvant treatment, had a good performance status (0-1) and had a tendency to have warm hands. When variables were combined in a multivariate logistic regression model, those that were associated with an increased risk of PPE were younger (< 65) had no metastatic disease, an inflammatory condition as co morbidity, drank alcohol regularly, had a good performance status, had not received previous radiotherapy, were overweight or obese, had a pre treatment creatinine clearance of 30-50mls/min and had a tendency to have warm hands. Conclusions: Similarly to the literature, contradictory findings were seen between the two samples within this study. There was only one variable that was associated with the development of PPE prior to cycle 4, which was the absence of metastatic disease. Limitations of retrospective data may explain variation in some variables which may have been underreported; however it is likely that it is not possible to identify specific factors that increase the risk of PPE. This is the first study to have collected and analysed data related to friction, pressure and heat causing activities. These activities have been suggested as increasing the risk of developing PPE and form the basis of patient education to avoid these activities. Data from this study indicates that only a tendency to have warm hands is associated with an increased risk of PPE. Whilst this finding would need validating in larger studies, it is a unique contribution to the body of knowledge of PPE. This finding indicates that avoidance of activities that cause friction and pressure has no evidence base. Patients may therefore be avoiding activities that add to their enjoyment which at this stressful time in their lives may add to any psychological distress. Despite limitations of this study, the importance of the findings presented here lie in its usefulness in shaping future research to investigate identified variables, where before no direction was available.

A fasciite plantar é considerada a terceira doença mais comum em corredores. Apesar dessa alta prevalência, sua patogênese ainda é inconclusiva. Na literatura desalinhamento do retropé, mudanças na conformação do arco longitudinal plantar e um aumento da carga mecânica sobre os pés, têm sido embasados como fatores de risco para o desenvolvimento da fasciite plantar. No entanto, há uma escassez de estudos que investigaram estes fatores, durante a corrida. A maior parte da literatura investigou, especificamente, a marcha e os resultados apresentam-se controversos e ainda não claros, principalmente, em relação ao efeito da dor associada à doença. Para alívio da dor, a maioria dos tratamentos baseia-se na inserção de palmilhas, porém, há longo prazo, elas não impedem as recidivas dos sintomas. Isso pode ser justificado pela carência de bases científicas que melhor descrevam as características posturais do complexo tornozelo-pé e os padrões dinâmicos da carga plantar, durante a corrida, para que possam perpetuar uma maior eficácia deste tipo de tratamento. Assim, o objetivo geral desse estudo foi verificar a influência da fasciite plantar com e sem dor sobre o alinhamento do retropé e o arco longitudinal medial na postura ortostática bipodal, bem como a análise da distribuição da pressão plantar durante a corrida. Foram estudados 105 corredores adultos de ambos os sexos entre 20 a 55 anos. Destes 45 apresentavam fasciite plantar (30 com dor - FPS e 15 sem dor - FPA) e 60 eram corredores controles - GC. Para responder as questões científicas específicas foram realizados dois experimentos. O experimento um teve como objetivo específico avaliar a influência da fasciite plantar sintomática e assintomática sobre o alinhamento do retropé e o arco longitudinal medial durante a postura ortostática bipodal de corredores recreacionais. Para tanto, foram avaliadas, por meio da fotogrametria digital, duas medidas clínicas: ângulo do retropé e o arco longitudinal medial. O experimento dois teve como objetivo específico investigar e comparar a distribuição da pressão plantar de corredores com fasciite plantar sintomática e assintomática e corredores sem a presença da doença, durante a corrida. Para tanto, a distribuição da pressão plantar foi avaliada por meio de palmilhas capacitivas (Pedar X System) durante uma corrida de 40m a uma velocidade de 12km/h, utilizando um calçado esportivo padrão. A dor foi mensurada pela escala visual analógica. Para análise das variáveis biomecânicas da pressão o pé foi dividido em seis áreas: retropé lateral, central e medial, mediopé e antepé lateral e medial. Os principais resultados desse estudo mostraram que a fasciite plantar sintomática e assintomática não apresentou diferenças significativas no alinhamento em valgo do retropé, mas a condição de fasciite plantar influenciou no arco longitudinal medial, onde ambos os grupos com fasciite plantar (com e sem dor) apresentaram um arco mais elevado em relação ao controle. Já em relação às cargas plantares, durante a corrida, não houve diferença significativa nas variáveis: pico de pressão (p = 0,609), área de contato (p = 0,383), tempo de contato (p = 0,908) e integral da pressão (p = 0,504). Conclui-se que a fasciite plantar sintomática e assintomática não altera o alinhamento do retropé na postura ortostática bipodal e a distribuição da pressão plantar, durante a corrida. No entanto, a condição fasciite plantar, independente do sintoma de dor, associa-se com um aumento do arco longitudinal medial na população de corredores / The plantar fasciitis has been the third most common disease in runners. Despite this high prevalence, its pathogenesis is still inconclusive. In literature, the rearfoot misalignment, changes in the conformation of longitudinal plantar arch and increased mechanical load on the feet, have been described as risk factors for developing of plantar fasciitis. However, there are few studies investigating these factors during the running. The most of the literature investigated the gait and the results are still controversial and unclear, mainly on the effect of pain associated with disease. For pain relief, most of the treatments are based on use of the insoles, however, they do not have long-term beneficial effects. This can be explained by the lack of scientific evidence that describe the characteristics of postural ankle-foot complex and dynamic load patterns on plantar surface during the running, thus, improve effectiveness this type of treatment. The general purpose of this study was to investigate the influence of plantar fasciitis with and without pain on the rearfoot alignment, longitudinal medial plantar arch in bipedal standing posture and on the plantar pressure distribution during the running. One hundred and five adult recreational runners of both sexes between 20 to 55 years old were studied. Of these, 45 had plantar fasciitis (symptomatic 30 SPF and asymptomatic 15 APF) and 60 controls runners CG. Two experiments were realized in order to respond the specific scientific questions. The first experiment had the specific purpose of verify the influence of plantar fasciitis symptomatic (with pain) and asymptomatic (without pain) on the rearfoot alignment and on the longitudinal medial plantar arch during bipedal standing posture of runners. Therefore, were evaluated by mean of digital photogrammetry, two clinical measures: the rearfoot angle and arch index. The experiment two aimed specifically to investigate and comparing the plantar pressure distribution in runners with plantar fasciitis symptomatic and asymptomatic and runners without plantar fasciitis during the running. Therefore, the plantar pressure distribution was measured by capacitive insoles (Pedar System X) during a running of 40 m at a speed of 12km/h, using a standard sport shoes. Pain was measured by visual analogue scale. For analysis of the pressure variables, the foot was divided into six areas: rearfoot lateral, central and medial; midfoot and forefoot medial and lateral. The principal results of this study showed that the symptomatic and asymptomatic plantar fasciitis do not show significant difference in the valgus rearfoot misalignment, but the condition of plantar fasciitis (symptomatic and asymptomatic) caused an increase of the longitudinal medial plantar arch compared to CG. In relation to the plantar loads during the running, there was no significant difference on pressure peak (p = 0.609), contact area (p = 0.383), contact time (p = 0.908) and pressure integral (p = 0.504). We concluded that the symptomatic and asymptomatic plantar fasciitis does not change the valgus rearfoot alignment during bipedal standing posture and the plantar pressure distribution during the running. However, the condition of symptomatic and asymptomatic plantar fasciitis showed an increase in the longitudinal medial plantar arch of recreational runners

OBJETIVOS: Comparar o tratamento por ondas de choque radiais com a fisioterapia convencional na fasciite plantar. MATERIAL E MÉTODOS: Foram tratados 40 pacientes com diagnóstico de fasciite plantar. Os pacientes foram divididos, de forma aleatória em dois grupos. Grupo 1 - constituído de 20 pacientes, que fizeram 10 sessões de fisioterapia com ultra-som, cinesioterapia e orientação domiciliar de alongamentos. Grupo 2 constituído de 20 pacientes, que fizeram três aplicações, uma vez por semana, com ondas de choque radial e orientação domiciliar de alongamentos. Todos os pacientes passaram por uma avaliação de dor e função antes, depois e após 3 meses do tratamento. A média de idade foi 49,6 ± 11,8 (25-68) anos, 85% gênero feminino, 88% estavam acima do peso, 63% tinham comprometimento bilateral e 83% usavam analgésicos regularmente. RESULTADOS: Os dois tratamentos foram eficazes na melhora da dor e função dos pacientes com fasciite plantar. O efeito das ondas de choque foi observado em tempo menor. CONCLUSÃO: O tratamento com ondas de choque não foi mais efetivo que o tratamento de fisioterapia convencional, quando avaliado três meses após o final do tratamento / OBJECTIVE: To compare radial shockwave treatment and conventional physiotherapy for plantar fasciitis. MATERIALS AND METHODS: Forty patients with plantar fasciitis were included in this study. They were randomly divided into two groups. Group 1 - was composed of 20 patients who underwent 10 physiotherapy sessions each, consisting of ultrasound, kinesiotherapy and instruction for stretching exercises at home. Group 2 - was composed of 20 patients who underwent three applications of radial shockwaves (once a week) and received instruction for stretching exercises at home. Pain and function were evaluated before treatment, immediately afterwards, and three months later. The mean age of the patients was 49.6 ± 11.8 years (range 25-68); 85% were female, 88% were overweight, 63% had bilateral impairment, and 83% used analgesics regularly. RESULTS: Both treatments were effective for pain reduction and for improving the functional abilities of patients with plantar fasciitis. The effect of the shockwaves was apparent sooner than physiotherapy after the onset of treatment. CONCLUSION: Shockwave treatment was no more effective than conventional physiotherapy treatment when evaluated three months after the end of treatment